Emergency Care

If you’re visiting the website outside of normal hours or need immediate medical care, please contact your regular veterinary hospital or if need be one of the local emergency clinics listed on this page.

(Keep the phone numbers for your vet, the closest animal emergency center and the National Animal Poison Control Center (NAPCC) in a place that’s easy to find (see below for a short list). Also, take a drive by the ER during daylight hours, to be sure you can find it in an emergency when you may be panicked and not thinking clearly.

Bloat (stomach overfilling with air/gas and possibly twisting)
Signs: Dogs may act very uncomfortable, pacing, hypersalivating (drooling), trying to vomit/retching, or be very nauseated. Dog’s abdomens may appear distended, gums may be pale and they may collapse.
Action: Go to the ER as soon as possible. This is a real emergency where time counts. There are some mild cases where you can get the dog to burp by getting them to stand on their rear legs (like dancing with them) and it can bring up the gas and they can recover for a while, but don’t waste time doing this if it doesn’t work right away, because this condition can become life threatening very quickly.

Male cats straining to urinate (some kind of obstruction/stone/crystals/swelling/infection in the urinary tract blocking flow of urine)
Signs: Frequent visits to the litter box with no urine production, pacing and crying (sometimes near the litterbox), small amounts of urine (sometimes bloody) in inappropriate places. They can lose their appetite and even vomit, and become listless.
Action: Go to the ER. This is another real emergency where time counts.

Trouble breathing (can be caused by a number of illnesses)
Signs: Increased respiratory rate, increased abdominal effort to breathe (belly moving dramatically with each breath), increased respiratory noise, shallow breathing, gums pale (or any shade of blue rather than pink), breathing signs may be combined with an inability to lie down or lying down in a prone (sphinx-like) position.
Action: This is always considered an emergency. Go to the ER

Bleeding
Signs: Any kind of bleeding may be an emergency or it could just be a temporary response to trauma – like in humans. It is useful to pay attention to how much and how fast the blood is coming. Ears, tongues and tails bleed and bleed (often justifying an ER visit). Sometimes blood in the urine looks like a lot, but it’s really just diluted in the urine. It needs to be treated, but may not be an emergency (ask a vet). Also, although it’s not pleasant and can be a severe problem, many dogs have diarrhea with blood and it is only temporary.
Action: This one is a judgment call…use common sense. You might ignore a mild cut and go back to sleep but obviously you should race to the ER even in your pajamas if blood is gushing. Cuts will bleed, but usually can be stopped with pressure or a bandage where possible. Try to elevate the bleeding body part above the heart and apply pressure to the bleeding area for several minutes. Excessive bleeding that doesn’t stop is an emergency. Bleeding toenails stop bleeding when you apply a quick-stop powder, styptic pencil, bar-soap shavings, cornstarch, or tea leaves (from a used tea bag) with firm pressure to the bleeding nail. It should stop after a minute or two.

Trauma from being hit by a car
Go to the ER. Even if animals appear fine after being hit by a car, it is best to have them checked at a vet as soon as possible. Internal injuries (bruising to the heart muscle, contusions on the lungs, small hairline fractures, etc) can be missed by the untrained eye.

Prolonged vomiting (for more than a day)
Animals that cannot keep food or water down at all for more than a day will probably need a visit to the ER. There is a difference between regurgitation and vomiting. Regurgitation is usually shortly after eating and the food has not been altered much by digestion. Some dogs or cats eat too quickly and regurgitate. Then they may try to re-eat that regurgitated food (gross, but not a big deal if they eat more slowly and keep it down). It is good to note what is being vomited up. Is it early morning vomiting on an empty stomach, yellowish (bile) fluid? This is likely to be less of an emergency and more a chronic diet/acidity issue. Is it a few pieces of fabric or a toy or plastic pieces and you’re concerned there might be more still in them? This is more of an emergency. Sometimes dogs just use the dog motto (“I think I’ll eat this and if it isn’t good for me I’ll vomit it up”) and they are then done. This is not an emergency, unless it’s a toxin (see below).
Note: don’t keep giving food to a vomiting animal. If they are vomiting water also, withhold that too and call a vet or your ER.

Allergic reactions (often to insect bites or contact allergens, sometimes reactions from vaccines or other injections)
Signs: Swelling of the face or other parts of the body, rashes, painful areas of skin, itchiness, discomfort, shaking head/ears, pacing, vomiting, diarrhea, lethargy
Action: It is always useful to keep Benedryl in the house for occasions like these. A dog’s dose in milligrams is the same as its weight in pounds. For example a 25 lb dog can take 25mg tablet of Benedryl up to every 8 hours to help with an allergic reaction (a 50 lb dog takes 50 mg or two tablets, and so on). Give it right away. A dose of Benedryl is usually safe for nearly all dogs, and it can really make a difference. It can also cause sleepiness, and increases thirst. Note: For smaller pets, keep a bottle of the children’s Benedryl around and dosing is easier (1 tsp is 12.5 mg of Benedryl).

Lethargic puppies/kittens
Go to the ER. Often they are hypoglycemic, but need care. You can start by putting honey or syrup on the gums and get to the vet. Make sure they are not cold – warm them up with a blanket or hot water bottle (not heating pad or anything from the microwave – they can get too hot).

Heat stroke
Heat stroke can occur if the animal is exposed to high temperatures (over 100 degrees without water or shade, or even less, depending on their health and age). Ambient temperature can be as low as 70 degrees but the temperature in a car even with windows open can climb to over 100 very quickly (minutes!). Be careful leaving animals in cars!
Signs: Animals can show heat stroke in many ways: panting, restlessness, vomiting, excessive salivation (thick ropey saliva), stumbling gait, seizures, collapse.
Action: If you can take a rectal temperature and it’s over 104 just due to heat stress, go to the ER. You can cool them by using cool-ish (not ice cold) water all over, especially in groin area, on the feet and head and get to vet. DON’T USE ALCOHOL. It can be absorbed and be toxic to the animal (old remedy, not recommended). A veterinarian may need to give IV fluids and other treatments to stabilize the pet. This can be life threatening very quickly – especially for cats.

Choking animals (known or unknown obstruction or foreign body obstructing airway)
Signs: depending on the cause and severity of the obstruction they may suddenly collapse from no oxygen. Or they may be partially obstructed and paw at their face/mouth, try to vomit, lie down in odd positions, run around with their neck stretched out, salivate excessively.
Action: This can be a real emergency, so trying to clear the airway may be tried before going to the ER. Getting a clear airway is an emergency where seconds, not minutes, count. If an animal has an object stuck in its mouth/throat, you can try to remove it if visible, but avoid getting bitten (put something in the mouth to hold it open for you, a cloth, roll of thick tape, etc). The Heimlich maneuver can be used also applying quick pressure just under the ribs. Use a two-handed fist (one hand covering the other) and aim up and in towards the head. You can try this several times. Sometimes the obstruction is dislodged, but the dog won’t start breathing unless artificial respiration or CPR is performed. This type of action is beyond the scope of this article, but animal CPR courses are available.

Electrical cord shock (Usually from chewing on electric cords)
Signs: Electric shock can cause anything from no injury, to a mild oral trauma at the base of the teeth, to severe life-threatening injuries (fluid in lungs from the shock can be a severe problem, etc). Signs can be difficult to assess without help of an exam and a radiograph. They can include, hypersalivation, panting, trouble breathing, dizziness, walking oddly, visible burns/lesions in the mouth, and a chewed electrical cord…
Action: If there was an electrical shock, you need a veterinarian to assess the damage, and possibly pain issues, with an exam and possibly a radiograph. Go to your vet or an ER.

Lameness (Not using a leg properly)
Signs: These can vary, as will the Actions: A lame animal that can bear some weight on the leg and is otherwise acting normally does not usually need a visit to the ER and may wait for a regular vet appointment. But when an animal is not using a leg (or legs) at all, suddenly can’t get up on its own power, or if there is bleeding or any significant swelling or pain in a limb, it can be time to get to the ER.

Eye problems
Signs: Tearing, moderate discharge, the whites of the eye looking more red are all signs of moderate eye issues that usually can wait for a regular vet visit. Any eye problem that involves any squinting/shying away from light, significant eye swelling or bleeding from the eye, or animals showing significant pain are an emergency.
Action: go to the ER if there are any of the latter signs. Otherwise, see your regular vet to check milder eye issues.

Seizures (involuntary twitching/convulsing, sometimes accompanied by involuntary urination or defecation)
Signs: Twitching can be just local (snapping motions with just the muzzle or jaw) or it can involve the whole body – paddling and shaking etc. The animal usually is not in pain during a seizure and is most likely not aware of the seizure. If the episode lasts more than one or two minutes or returns immediately, or they come in clusters, it is an emergency. First-time seizures are in the emergency category because the cause may be determined to be something treatable if caught early enough (toxin, illness, etc).
Action: Generally, it is best to see a vet or go to the ER immediately if your animal has a seizure for the first time and it’s undiagnosed. Don’t worry about them “swallowing their tongue” – you’ll only get bitten and they won’t swallow their tongue anyway. Just try to keep them from falling or injuring themselves, and keep them cool – prolonged seizures can dramatically increase body temperatures. Also go to a vet if the seizures are prolonged or are in clusters, or the animal’s temperature starts to rise due to the seizure. It is possible to try gentle eye pressure to help decrease the heart rate and calm a seizure, but if there’s a lot of shaking, uncontrolled poking at the eyes can cause damage, so just get to the ER.

Anorexic Cats (not eating)
Any cat that has not eaten anything in over 24 hours should be seen by a vet. Not eating is a life-threatening situation for a cat, especially an overweight cat. You can try offering foods that are warm, that have extra warm water added, or that have a new flavor to tempt them.

High fevers (normal temp in dogs and cats are about 101-102.5 degrees)
Anything above 103.5 should be assessed. Over 104 should go to ER for sure.

Dog/animal bites
Better to treat any punctures right away with antibiotics (go to ER) and significant lacerations may need suturing and antibiotics. Often these animals need pain medication as well.

Ingesting Toxins, Including Chocolate/Cocoa
Dark chocolate and baking chocolate are the most serious. How much chocolate is really toxic?

One ounce per lb of body weight for milk chocolate is a toxic dose.

One ounce per three lbs of body weight for semi-sweet chocolate is a toxic dose.

1 ounce per nine lbs of body weight for baker’s chocolate is a toxic dose.

Xylitol (sugar-free sweetener in gum, some candy and baked good is VERY toxic to pets)

Antifreeze (one tsp can be toxic to a seven lb dog or cat)

Easter Lilies are toxic to cats (all parts of the plant including pollen) NOTE: tigerlilies, japanese show, stargazers, daylilies & lily of the valley are not really lilies and are therefore not poisonous

Unfortunately there are many other toxins that we can’t list here, so if your pet ingests anything unusual, it’s best to call a vet or the National Animal Poison Control Center (NAPCC) for information.
Action: Call your veterinarian or the National Animal Poison Control Center (NAPCC) immediately (see below). Give them the type of animal you have, its weight and as much information about what the pet has ingested as possible: the label, when it was eaten, exactly how much, etc. Don’t induce vomiting without consulting a veterinarian first. Sometimes toxins or other substances do more damage on the way back up than they do on the way down. When advised to induce vomiting, you can do so by giving fresh hydrogen peroxide orally–about one ml per pound of dog–which is about 1/8 cup for a 30 lb dog, and 1/4 cup for a 60 lb dog, etc.

‘Tis the Season…
During the holidays, pets are exposed to many toxic or dangerous seasonal items. Even one or two mistletoe berries can be extremely toxic for a pet. On the other hand, poinsettias are only irritating to the mouth and are not as toxic as people believe. Decorations, electrical cords, tree ornaments, tinsel are all possible dangers to pets. Holiday candy should be kept away from pets: chocolates, and even sugar-free candies with Xylitol are toxic. Don’t leave wrapped gifts that are food/candy under the tree where animals can get to them. Animals may try to drink the water for a Christmas tree, so don’t put in chemicals. Not to mention the increase in rich, tempting foods that can cause serious illness for pets eating leftovers. Think twice before giving something totally new and rich to your pet. Your holidays will be much happier without a trip to the ER.

The final bit of advice; if you’re not sure, CALL the ER! Usually they can help you decide the best course.

Pet First Aid Kit:
Here is a list of things that come in handy when you’re dealing with a pet problem or getting veterinary advice over the phone.

Digital thermometer

Quick-stop powder for nails

Vet wrap or Ace bandages

Tweezers

Ice packs or frozen baby peas

Artificial tears

Triple antibiotic ointment and Cortisone cream

Benedryl liquid (small pets) or tablets (over 25 lbs)

Hydrogen peroxide (fresh bottle every 6-12 months)

Pedialyte

Cotton balls

Animal ear cleaner

Pet shampoo (not human)

Exam gloves

Feeding syringe

Muzzle if needed

Carrier if appropriate

Equally important when dealing with gastrointestinal problems:

White rice (not minute rice)

Unsweetened canned pumpkin (about one tblsp per 30 lb pet)

A few jars of Stage II meat baby food (chicken, lamb, etc., no onion powder) are useful bland foods for GI problems and a great way to give oral medications.

Q: How do I know if there’s an emergency with my pet? I recently spent about four hours in an emergency room with my labradoodle, “Hudson”, who had eaten half a box of milk chocolate. They made him vomit it up although it wasn’t a toxic dose, because it might make him a little sick. Then they sent us home with some Pepcid and bland food. I felt a little foolish, though, because there were animals there in worse condition. How do I decide what problems merit a visit to the ER and when to wait it out?

First, don’t feel foolish. It’s never foolish to see a vet if you’re concerned about your pet. Sometimes you can get helpful information over the phone if you call first. Unfortunately, there are many problems that can’t be assessed over the phone and a visit to the Emergency Room (ER) is unavoidable. Emergencies depend on both the animal’s condition and the owner’s ability to deal with the problem. Although a bleeding tail tip may not be life threatening, if an owner can’t stop the bleeding and needs help, it becomes an emergency.

Patients & Friends

Excerpt from “The Royal Treatment” –

ALLERGIC PETS

An itchy pet may not be a medical emergency, but it is often a mental emergency.

Allergies are a big issue in veterinary medicine. Although a sneeze can be an initial sign of allergy, a more common sigh of allergy is itching. Itchy dogs and cats chew at their skin and feet, scratching, licking, irritating, and even ulcerating skin. Itching is distressing for both pets and owners. It's hard to live or sleep with a per that can't stop scratching. The irritated pet can really weigh on the mind. Not to mention the extreme discomfort the pet is going through.

Not only are people allergic to animals, but animal are allergic to our world, too. I use the analogy of a cup overfilling when I explain allergies to my clients. As long as the cup isn't brimming over with allergens and immune problems, the animal won't show any signs of irritation. However, when the cup runneth over, the itchy signs maketh themselves known.

Note: Some of my clients have been told that their pet is allergic to meat. I believe it is highly unlikely that a carnivore is allergic to meat. Although I know it can be true, it should be the exception, not the rule. More commonly, the culprit is the chemicals in processed meats or poor-quality meats, or the grains and chemicals in the processed food irritate an animal's GI tract, making the intestines a poor border protector. An unhealthy GI tract may allow more antigens into the bloodstream. When a food change alleviates allergies, it is more likely because the food improves the health of the GI tract by providing a good protein content, and fewer grains of chemicals. A healthy GI tract makes all the difference in resolving allergies.

Dr. Royal has formulated a new line of raw food available by prescription for kidney and liver conditions. Click here to learn more.